Controversy, Skincare

Dr Albert Kligman and the Horrors of Holmesburg Prison

October 20, 2022November 29, 2022 by Nia Patten

Skincare with Friends Ep 82: Dr Albert Kligman, the Creation of Tretinoin and the Horrors of Holmesburg Prison

This is going to be an unusual episode of Skincare with Friends, where we try and figure out how it comes to be that someone can devote themselves to making human existence better for everyone and simultaneously perform monstrous acts of cruelty.

You might remember us talking about a certain Scientist in our last episode- a Mr Kligman, who has his name on many studies that we have referenced on the podcast. You might remember us saying last time that Dr Kligman performed the original comedogenicity studies on rabbits in 1972, and then we mentioned that later experiments were done on adult males’ backs. We were worried about the cruelty inflicted on the rabbits, but didn’t question the treatment of the human guinea pigs. It turns out that the human test subjects were treated with as much respect as the rabbits.

I have no wish to revel in people’s suffering or titilate our listeners with gory details but I think it’s really important that we all understand that there was human suffering involved in the creation of the skincare that we are all enjoying. To give back to our podcast and to help to keep it going subscribe, like, share, buy us a Kofi, and leave a nice comment :-). To read more about Tretinoin, check out our other posts.

I certainly feel very sheepish about the praise I was piling on Albert Kligman both on the podcast and in my brain when I was reading the studies. After editing the podcast last week, I did a cursory Google of our Kligman (not Quincy) and it turns out he was far more controversial than I had hoped. In my defence, when I read the studies, there is not a single mention in the publications about any wrongdoing. I think there is a certain amount of glossing over of the facts in the science community.

Background- How the Prison Experiments Came About

Albert Kligman lived from 1916 to 2010. He died when he was 93 years old and was involved in publishing research on dermatology until 2009.

From the office of the dean of Pennsylvania University-

“Albert Kligman published in more than 1,000 research papers and 20 textbooks, and has benefited millions of people. This work includes the initial discovery of the effects of retinoic acid on acne as well as seminal discoveries in our understanding and treatment of common disorders such as aging skin, seborrheic dermatitis, ringworm, and alopecia. However, the committee also determined that, while Dr. Kligman’s experimental protocols conformed to legal standards of the time, some of this work raised serious ethical concerns”

His research focused on skin conditions like acne, rosacea, dry skin, aging, photo damage. In 1969 he co invented Tretinoin, and in 1975 he created Kligman’s solution- a combination of Tretinoin, hydroquinone, kojic acid and a steroid, which is unarguably the most effective treatment available for hyperpigmentation.

From 1951 to 1974 Dr Kligman was involved in carrying out a great number of experiments on the prisoners incarcerated in Holmesburg prison, lots of these experiments had nothing to do with skin.

They initially included medicated skin creams for treating various ailments, such as ringworm, herpes and bacteria like staphylococcus aureus.

Other tests exposed prisoners to to biological agents, such as dioxin (which is a toxic chemical used in herbicides and an ingredient in Agent Orange) and hallucinagenic drugs (as part of a federal government program known as “Project Often”). (The Daily Pennsylvanian)

What Happened in Holmesburg Prison

Let us set the scene. Who are the villains (almost everyone) who are the heroes (few and far between in this story)

Holmesburg Prison, given the nickname “The Terrordome,”was a prison in the centre of the city of Philadelphia, Pennsylvania and operated from 1896 to 1995. Holmesburg has a dark history, even without the presence of Klig, we haven’t got time to get into it, but safe to say the prisoners were not treated with respect or fairness during their time there. (Read abandonedamerica.com)

Lots of the information on the personal experiences of the experiments in this podcast comes from a book called “Acres of Skin” by Allen Hornblum in 1998. Hornblum was employed as a literacy instructor in Holmesburg prison, Pennsylvania in the 70s, he was there at the time of the experiments. He was “convinced the medical research was problematic and there was probably quite a story behind such a large medical research operation in a city jail.”.

This is what Allen Hornblum said about his experience- “When I first started working in the Philadelphia Prison System in 1971, I was stunned to see scores of prisoners strapped and wrapped in gauze pads and adhesive tape. Rather than a knife fight on the cellblock or a gang war in the exercise yard, the medical dressing was part of a vast and long running clinical trial program. In short, a prominent dermatologist and an Ivy League university had taken over the city jail and turned it into the nation’s largest human research program testing everything from hair dyes and athletes foot medication to Phase I drug trials, dioxin experiments, and chemical warfare agents.” (From the anaphora literary press)

How Albert Came to Be at the Prison

Albert Montgomery Kligman was born on March 17, 1916, in Philadelphia, the son of Jewish immigrants. His father, born in Ukraine, was a newspaper distributor; his mother, born in England, was a sales clerk, and educated in the Philadelphia public school system, ”Rejected by both the Army and Navy because of a recurring pilonidal cyst (a bum boil), he followed the advice of his first wife of three and entered medical school”

Albert M.Kligman became a Phi Beta Kappa graduate of Pennsylvania State College in 1939, and at 31 yrs old in 1947 acquired both a Ph.D. and M.D. from the University of Pennsylvania. Kligman came from humble surroundings and was able to complete his undergraduate career only with the financial assistance of Simon Greenberg, a local rabbi who took an interest in the precocious student. So it doesn’t sound like he came from a wealthy background.

Apparently he was a very impressive person to be around, full of energy and a great teacher. He was also described as a poor scientist by some observers. Known to move on too quickly from a study before the work was truly finished. Dr. Fred Urbach, Temple University’s dermatology department chair for over three decades, says, however, that Kligman was a “fascinating person” with “two speeds—bloody genius or wrong.”

A prolific author, Kligman wrote scores of medical articles on a variety of dermatological subjects. His earliest works, written in the early 1940s, before he entered medical school, concentrated on the mushroom. This unusual interest stemmed from the fact that Kligman had received his doctorate in botany (mycology), specializing in the study of fungus. (This interest in fungus is an important detail for later on)

In a study of ringworm (tinea capitis) that was published in a leading dermatology journal, Kligman wrote:

“The data reported in this paper derive from observations on experimentally infected humans. The work was carried out at a state institution for congenital mental defectives where tinea capitis was endemic and the inmates subject to constant opportunity for infection. The experimental circumstances were ideal in that a large number of individuals living under confined circumstances could be inoculated at will and the course of the disease minutely studied from its very onset. Biopsy material was freely available.”

So Kligman was running riot in this institute, biopsy material freely available indeed!!! That so called “material” was disabled children’s scalps. Dr. Kligman would describe how he encouraged the development of ringworm by rubbing it into the abraded scalp skin of retarded (not my words) children. Kligman would delight an audience of medical students and residents-in-training by telling them: “These kids want attention so bad, if you hit them over the head with a hammer they would love you for it.” page 35 AoS.

“In 1956, Dr. Kligman evidently combined retarded children and prisoners in the same study. He received a research grant of $13,949 from the Public Health Service, National Institutes of Health, to look into the structure of the nail and Kligman listed two classes of subjects: individuals (to be found in hospitals and clinics) with spontaneous nail disease; and human volunteers (prisoners) in the Philadelphia County Prison, who “for a modest fee provide us with ideal opportunities.” Kligman planned to take “punch biopsies from various portions of the nail folds, the nail matrix and the nail bed to determine the subsequent effects on growth and recuperation… In addition to removing portions of the nail organ surgically, we shall study the effects of applying caustic agents.”

Dr. Kligman claimed, “Work on fingernails has been almost non- existent because of the obvious difficulties in obtaining biopsy specimens… (because it’s fucking painful) But in a preliminary survey we have convinced ourselves that the nail organ is a hardier structure than previously supposed and will tolerate a good deal of insult without permanent disability.” Confidently, Kligman proceeded to use X-rays and a host of fungi on the test subjects.” AoS p59

I had to include that piece from Acres, it’s so very dark. We all know how painful a nail injury is, if you’ve ever had a hangnail then you know nail pain. This supposed doctor injured the nail beds of vulnerable people and was pleased as punch that he managed to find someone who he could freely abuse.

Let me juxtapose that horror with an obituary by a British dermatologist Dr. Shyam Verma International Journal of Trichology in 2010, wrote, “he got bad press for the ‘infamous’ experiments that he conducted in an American prison on inmates and the press hounded him probably much more than what was required. That was the price he paid for being famous.”.

Anyway!! Back to how Albert came to be at the prison-

Medical research under Dr. Albert Kligman began in the county penal system in 1951 when Holmesburg Prison was suffering from another outbreak of athlete’s foot, a malady common to a large, unsanitary, residential facility. Many of the 1,200 prisoners had been diagnosed with the fungus infection and the institution’s insubstantial medical staff was looking for a cure. The prison pharmacist came across an article written by Albert M. Kligman, professor of dermatology at the University of Pennsylvania Medical School, and called the author to ask for help. Big mistake.

When Dr. Kligman arrived at Holmesburg he was excited by the potential it held for his research. In 1966, he recalled in a newspaper interview: “All I saw before me were acres of skin. It was like a farmer seeing a fertile field for the first time.” The hundreds of inmates walking aimlessly before him represented a unique opportunity for unlimited and undisturbed medical research. He described it in this interview as “‘an anthropoid colony, mainly healthy’ under perfect control conditions.” This actually made me well up. The definition of the word Anthropoid is “resembling human”. In his own words, he doesn’t’ see the inhabitants of the prison as being quite human.

“Many of the prisoners, for the first time in their lives, find themselves in the role of important human beings. We say to them, “You’re important, we need you.” Once this is established, these guys will knock their brains out to please you. If the experiment does not pan out, they get depressed. They become emotionally involved in the project. The capacity to respond to love is greater than most people realize. I feel almost like a scoundrel—like Machiavelli—because of what I can do to them.”

As he told colleagues years later, “I began to go to the prison regularly, although I had no authorization. It was years before the authorities knew that I was conducting various studies on prisoner volunteers. Things were simpler then. Informed consent was unheard of. No one asked me what I was doing. It was a wonderful time.”

You might hope that this monster was a bad apple in a barrel of decent scientists and doctors who would condemn such disregard for human kindness. Kligman presented some of his data at the 12th annual meeting of the Society for Investigative Dermatologists in 1951, Kligman’s presentation was met with praise for selecting an “ideal,” test population. The appreciative reviewer commented: “We have not been alive enough to the wealth of test material that there is in penitentiaries” there was zero condemnation among his peers. p33 AoS

How was Tretinoin Developed?

Dear dear listeners might be wondering why all this relates to you, As skincare people I think it’s our duty to learn the very real history of our beloved topicals.

Kligman is quoted as saying that in the early stages he experimented with “very high doses” of vitamin A, so high that “I damn near killed people [before] I could see a real benefit… Every one of them got sick.” Kligman was experimenting with very high dosages, sometimes orally. Eventually various derivatives of vitamin A were tried topically and the results were impressive.

“Retin-A®’s birthplace was at Holmesburg Prison,

These earlier studies used “1 percent vitamin A acid, in comparison to the .01 percent” adopted years later.

Dr. Chalmers Cornelius, also a resident during these years, says some of the “occlusion studies” resulted in “tremendous inflammation and the experiments had to be altered.”

Dr. Cornelius says that it was the inflammation that most attracted Kligman. Despite what many would have considered a caution sign, Kligman’s response was always the same: “Push on.” “He had that type of mentality—push on.

A former student of Kligman and a former director of the University of Pennsylvania’s Acne Clinic, Dr Joseph Witkowski says that he “thought [Retin-A®] would never sell. It caused a severe reaction in patients. Their faces became quite red and irritated. But Kligman has the capacity to keep pushing when others won’t. He could see the value of Retin-A® as possible therapy. Time has shown that it has positive results. It’s a fantastic drug. He’s a genius.”

The doctors continued to apply retinoic acid to the faces of Holmesburg inmates and patients at the university’s acne clinic. The vitamin A experiments carried on alongside the dioxin and LSD trials.

In 1969, Kligman, Plewig, and James E.Fulton, Jr., published a paper that reported:

“Vitamin A acid is a fairly potent irritant. Although most acne remedies inflame the skin to some degree, the effects of vitamin A acid are rather singular. Within 48 hours the skin becomes red and scaling. Despite prolonged usage, its irritancy does not greatly diminish; that is to say, there is only slight evidence of hardening. The skin tends to burn and sting for a short time after each application. Injudicious use may induce a flaming red, chapped, swollen face. The daily application has to be regulated in accordance with individual susceptibility. The aim is to apply that quantity which will maintain moderate redness and peeling. Discomfiture about the mouth and angles of the nose is particularly disagreeable if the medication is carelessly applied. Even with excessive use, the skin recovers within a few days after stopping treatment. Deeply motivated subjects should not be dissuaded from increasing the frequency of application for patients with the most irritated faces achieve the most rapid improvement.”

So at that point in the early 70s Retin-A aka Tretinoin was a proven anti acne treatment, but Kligman also believed that it had anti aging applications.The prison experiments had finished in 1974 so he had to continue his trials using mice so he could prove what he believed to be true.

Kligman chose rhino mice, an unusual species from Africa, because the mice develop rows of wrinkles from nose to rump, shortly after birth. The authors believed the wrinkle canals were filled with the same horny substance that formed pimples in humans. In their experiment, the mice received applications of Retin- A® twice a day for six weeks while a control group received none.

The results were incredible; after only three weeks the Retin-A® group had undergone a total mouse body transformation, they were practically free of wrinkles. The skin of the control group was covered by seemingly endless wrinkles. As the Kligmans said in their conclusion: “The outstanding finding was the capacity of retinoic acid to restore the bizarre architecture of rhino mouse skin to a nearly normal appearance. [T]he treated skin became as smooth as the…hairless mouse; the redundant folds and wrinkles were totally effaced.

What ensued next were years of ugly tactics from Dr K, to get RetinA known to the public so he could make lots of cash as quickly as possible. He teamed up with a company called Ortho (a subsidiary of Johnson and Johnson) and spent years paying doctors to promote the drug at various conferences to get the word out to dermatologists nationally and therefore to consumers via their Retin-A® Educational Program. In 1986 Ortho conducted an educational campaign that included a “consumer media tour” televising prominent dermatologists. The physicians were part of Ortho’s stable of company-friendly medical show horses, each of whom received a $1,000 stipend to visit local television stations and “discuss the damaging effects of the sun, precancerous lesions, and the benefits of Retin-A®.”. This was all before the FDA had given approval for Retin A as an anti aging drug, it had already been approved for acne but the New Drug Application for the wrinkles was going to take too long, and Klig and Ortho wanted to start making money now.

Klig got into trouble from the University of Pennsylvania as he was profiting from a drug that had been developed using the university’s resources and he wasn’t paying them their share unsurprisingly. He applied for the patent for RetinA under the trade name Renova under his own name and therefore breached intellectual property laws. He planned to allow the RetinA patent to lapse and therefore the Renova patent would bring him a lot more profit as he was the sole owner.

By 1991 the heat was coming not only from the university, the FDA but also from the governement, who were persuing criminal proceedings. Ortho responded by destroying all the documents relating to the drug. In 1992 the legal battle between Klig and the University ended with an out of court settlement, one source said he had to pay millions of dollars. This is what Dr K had to say about the matter-

“I didn’t know Retin-A® was going to yield all this wealth. I’m delighted, because it’s my way of paying back this university that trained me, educated me, gave me a chance to grow, and didn’t hold me back”.

Ep. 83 Skincare with Friends: Part 2 Albert Kligman and the Holmesburg Prison Experiments

Last episode we discovered the dark history of Albert Kligman and the discovery of Tretinoin. We learnt about Dr K’s journey to Holmesburg, how the most effective anti aging drug was developed at the cost of prison inmate’s safety and comfort. We got a picture of a man who was willing to throw vulnerable children and adults under the bus, as well as the university that employed him, in order to further his career and line his pockets. We learnt how the scientific community knew all about the experiments and thought they were a great idea. The prison were getting their cut and so was the university.

In Episode 2 of the story of the Holmesburg Prison experiments we are going to learn about the other experiments, how dark and low this supposed doctor got. Also understand a bit more about why the prisoners ended up in such a dangerous situation. And what happened afterwards, did they get any recompense?

What Were the Other Experiments?

We’re going to dive right in with the non tretinoin experiments. As we said last time Kligman’s experiments in Holmesburg ran from 1951 to 1974, so 23 years, ranging from cosmetics, toothpastes, athletes foot creams, poison ivy and oak treatments to radioactive isotopes, hallucinogenics and biological agents like Dioxin. Again thank you to my sources which are linked below and especially Allen

To quote Captain James Kinslow, who started working in Holmesburg in 1965- “Both inmates and guards say you can recognize a Holmesburg inmate decades later by the distinctive scars from skin burns and patch tests. He said “If you ever saw the guys on the beach, you would know where the hell they’ve been.”

Joseph Dade, a retired Philadelphia deputy sheriff and former Holmesburg guard, says, “Guys sold themselves for a few bucks. Guys looked like zebras when the patches came off.”

Just a note- In 1968, 85 percent of the prisoners at Holmesburg were black. I feel these abuses were race related, the sense that the prisoners were “other” and less than may well be related to race. Would it be different if the population was 85% white, we can’t know. Accusations circulated for years that black inmates were directed to the less desirable tests with lower payouts.

If you imagine for a moment that you’re devoid of empathy and humanity, in a way you can see why a prison holds such a great population for study subjects. They have a very controlled environment, reliable movements, you know exactly how long these men are going to be available for study, you can prevent them from using whatever stuff they might buy in the shop. If you are studying a normal group of patients, sometimes people just decide they are going to leave the study for some reason, or they change their diet or get pregnant or whatever people with freewill do. These poor men without freedoms were like sitting ducks.

There were different levels of experimentation. In the earlier days there were the skin experiments devised by K- the ringworm, nail bed stuff included. Once the word got out to the wider world that there was a doctor performing experiments on prisoners, other companies and organisations realised that there was a way they could pay to use the hundreds of men for whatever grim experiments they fancied carrying out. 33 different companies employed K to perform experiments on 153 chemicals including Johnson and Johnson, Dow, Pfizer, Merck, Hoffman-Larouche, Helena Rubinstein and Kline & French

A former prisoner and patient recounted how: “They used my body; they did things to me that were inhuman … I feel less than a woman (!!!!!) because of the things they did to me. This brought me pain. A lot of pain.” Such experiments did not simply affect the well-being of individual inmates, but also affected the health of entire cell blocks due to experimentation with biological agents including Hong Kong flu (The Hong Kong flu, also known as the 1968 flu pandemic, was a flu pandemic whose outbreak in 1968 and 1969 killed between one and four million people globally. It is among the deadliest pandemics in history), poison ivy and poison oak. So common was the experimentation that in the 1,200-person prison facility, around 80 percent to 90 percent of inmates were experimented on.

In March 2022 Johnson and Johnson published an apology in the BMJ for their part in some very dangerous experiments. The drug company Johnson & Johnson (J&J) has expressed regret after court documents unsealed in talcum powder litigation showed that it funded a 1971 study by K in which Pennsylvania prison inmates, most of them black, were injected subcutaneously with chrysotile and tremolite asbestos. wanted to compare the minerals’ effect on the inmates’ skin versus talc, which is a key ingredient in the company’s popular baby powder. The chrysolite form of asbestos had the biggest effect on inmates’ skin, causing granulomas, or cells clumped together in a raised area,” This apology only came after the company was forced to reveal information about the experiments during a completely separate legal case. They get no kudos for their apology.

Some Quotes about the Holmesburg Inmate’s Experiences-

Patch tests were the most common test, they were probably tests of cosmetics for irritancy or comedogenicity. An inmate called McGovern commented that he saw some inmates get “really messed up” in the tests, like the time “some guys on a shampoo test started to lose their hair.
That first test nearly killed me it was so painful. I nearly went through the wall. I had a patch put on my back that covered a large area. It was a 10-day test and I wasn’t allowed to take a shower,” he says. He received $10 or $15.
One of the more unusual experiments that Withers Ponton agreed to was what he calls the “gauze test.” With no anaesthetic, he lay on a table while “two young doctors from the University of Pennsylvania” cut two 1-inch incisions on each side of his lower back. They inserted gauze pads into the wounds, and then stitched up the incisions. Ten days later, Ponton returned, the doctors reopened one wound, removed the gauze pad, and restitched the wound. After another 10 days, Ponton was brought back for the same procedure on the other incision. He was never told the purpose of the exercise and accepted $20 for his trouble—“$10 for each cut.” He’s still angry that “now I got these scars all over my back.”
“I looked like a checkerboard with patches and skin discolouration on my arms, back and chest,” says Ron Keenan, a lifer at Graterford Prison, who spent 34 months at Holmesburg in the late 1960s while awaiting trial for the murder of a policeman. “I was on a lot of suntan tests because I was light-skinned,” but the patch tests “really irritated my back…. I [had] burn blisters for months.”

The Milkshake Test was a favourite among the inmates. Each day selected inmates went to H Block and drank “a rich, creamy-tasting ‘milkshake,’” something like today’s diet drinks. The test lasted anywhere from 30 to 90 days depending on the results [from] each…inmate. Two types of milkshakes were given out to the inmates: a vanilla- flavored concoction for the thinnies and a chocolate-flavored one for the fatties…. At first, [there was] a problem with the milkshake test: the first three weeks, the fatties gained weight and the thinnies lost weight and suffered dehydration. There was a mix-up where the milkshakes were being passed out. It took a while for the lab to work out the bugs.
Another experiment called for 20 prisoners to have Johnson & Johnson baby shampoo dropped into their eyes over a 24-hour period. The discomfort of such an experience was worth $3 to each man
The sweat test,” as Williams refers to it, placed inmates in an overheated chamber, after which their armpit glands were cut for examination. In another test, sutures were made in his body “to see if they would dissolve,” and in keloid tests, “some stuff [was] injected in his back” and then removed bit by bit. He claims to have had “part of a cadaver” implanted in his “back to see if it would grow,” but after a couple of days his “body rejected it.” Williams recalls participating in tests of Hong Kong flu, poison ivy, and poison oak. The patch tests, he says, were the easiest to endure because each time he returned to his cell, he, like other inmates, would “hang the patch on the wall.” There were a few tests that even Williams declined. He remembers “guys with big things attached to their faces and foreheads,” in what inmates called “the Cyclops Test.” “I didn’t do that, I was afraid of it…[and] I never did the liver and lung biopsies…they looked too scary and dangerous.” He describes “needles about a foot long”
Captain Gougnin, now in his seventies, spent 25 years working in the Philadelphia Prison System before retiring in 1978. He can quickly recall a long list of inmate experiments that included the usual, “shave creams, mouthwashes, deodorants, and detergents,” and the unusual, “women’s lingerie and soda water.” As with other guards who witnessed the unusual activity on Holmesburg’s H Block, he recalled one eerie scene after another. He remembers “burn tests” that left bad scars “on their quadriceps muscles.” The device used to burn the test subjects was referred to as a “ray gun” by the inmates. Gougnin says: “The burns went deep into the skin. I don’t know how the inmates submitted to that.” Gougnin periodically observed the doctors applying various salves to the burns. He remembers inmates walking around with devices designed to collect skin and perspiration, “1–1 1/2-inch stainless steel cups strapped to their foreheads.” He recalls “scalp transplants,” unsuccessful attempts to rejuvenate hair growth by moving an inmate’s “hair from the back of the scalp to the front.” The experiment that left a particularly strong impression on Captain Gougnin was one that nearly resulted in the deaths of seven inmates. He believes the experiment involved liver biopsies, which he claims had begun in the early 1960s and were quite common on H Block. But one weekend “seven patients almost expired” and everyone was in a “panic” when the university doctors could not be located
“I got a needle in my spine for $7,” says Ron Keenan matter-of-factly. “They put a chemical in, but for some reason it didn’t work,” and the experiment was canceled. In one “pill test” designed to “quicken the sun tanning process,” Keenan doubled up in pain with “cramps you wouldn’t believe” after swallowing four pills on H Block. They explained to him that this “was something new coming on the market” and he would have to go in “the exercise yard for 20 minutes every day for a week or two” in order to capture the sun’s rays. Keenan doesn’t recall if he developed a tan, but “the terrible stomach cramps” are still hard to forget.

Between the patch and diet tests, many experiments were compromised by wily inmates. Curiously, no one—including the prisoners, the medical administrators, or the pharmaceutical companies sponsoring the tests—seemed to care. “Inmates ran a con game on them,” says Al Bronstein, a long-time prison reform advocate and former Director of the National Prison Project. “Some of these studies were scientifically worthless.

The Radiation Experiments at Holmesburg

Kligman himself was keen to have a play around with radiation and without the acquisition of appropriate licences and safety measures went about doing so. He was interested in radiation as a cure for ringworm. He had previously used radiation to successfully treat the scalps of small children and wanted to explore the dangerous energy more fully. Apparently there were radiation experiments performed by Kligman at Holmesburg, but there is literally no record of what exactly he did with it.

We know he was playing with radioactive isotopes because he had illegally obtained a license to obtain radioactive substances which was then revoked when the authorities realised that he had no credentials or equipment for the proper and safe storage of the dangerous cancer causing radiation.

Dioxin and Holmesburg

Dow Chemical and the University of Pennsylvania joined together to test a dangerous chemical substance on the backs of Holmesburg Prison inmates.

Nearly six dozen inmates had been purposely exposed to something formally known as 2, 3, 7, 8-tetrachlorop-dibenzodioxin, or TCDD aka Dioxin, a by-product of the manufacture of the herbicide 2, 4, 5- T.

The substance had been “linked by scientists to cancer, birth defects and fetal cancer,” and a Harvard professor was quoted as saying that dioxin may be “the most powerful carcinogen known” to man. It is also used as Agent Orange, and was used in the Vietnam war with disastrous consequences.

I’m showing YN (young Natalie) a picture of Viktor Yushchenko, the Ukrainian president who was was poisoned with Dioxin, he has a particular appearance-lots of very large blackheads all over his face. This effect is known as “Chloracne” and is peculiar to Dioxin poisoning.

It was this reaction Kligman was trying to recreate on the prisoners with increasing doses of Dioxin. There had been an outbreak of chloracne at the Dow Chemical plant and the company were keen to investigate the link between chloracne and dioxin. They came to Klig to carry out these experiments in his prison laboratory and paid him $10k.

Kligman started with low doses and seeing no obvious effect, increased the dosage of 0.5 microgram by 456 times. On reading the reports they received from Klig, Dow were horrified to see how much Dioxin K had administered to the skin of the prisoners and shut the experiment down. (Information from Mr. V. Rowe, a consultant to the vice president for health and environmental sciences at the Dow Chemical Company)

The records on the experiments were destroyed by the prison, Dow Chemical, and the University of Pennsylvania for fear of litigation and the subjects weren’t even told what chemicals they were exposed to, which is terrifying considering the generational effects of this poison.

The Army Tests

After World War 2, the army wanted to test agents of chemical warfare. They tested atropine and LSD Among other things, hoping they could be developed as agents of chemical warfare.-

Drug	Symptoms
Agent 282	Grogginess and lightheadedness
Agent 834	Mental impairment and Hallucinations
CAR 302, 212	Light headedness
CAR 302, 368	Light headedness, slurred speech, and lack of drive
Agent 1-11 (Atropine Sulfate)	Dullness of consciousness, difficulty distinguishing reality from fantasy.
Agent 668	Mildly high symptoms and intoxication.

They brought an agent called EA3167 to Holmesburg prison for testing. It’s effects include both psychological and physiological effects, with the most incapacitating effect being a state of delirium characterized by cognitive dysfunction, hallucinations, and inability to perform basic tasks. The usual syndrome of physical anticholinergic effects are also present, including mydriasis (dilated pupils) (potentially to the point of temporary blindness), tachycardia, dermal vasodilation, xerostomia and hyperthermia. The effects last 5-10 days.

An inmate Al Zabala recalls his experience with the army experiments. Zabala believes he was given an injection of a substance “ten times stronger than LSD” and was kept in a padded room for a week. Except for the “trip” he has no recollection of his actions during that period.- “I wasn’t right for a month after the test. I was real subdued and quiet. I had problems swallowing food and a constantly dry throat. They put me on a liquid diet until I could swallow whole food again. When we finally came back to population, all the guys on the study had to wear badges that said we were not responsible for our actions and if we acted up to get U of P personnel to come and get us. We had to wear these badges for a month and once a week talked to the psychs. They made us take paperwork and association tests to measure our psychological condition. [A few] guys came back to population and didn’t remember their names. Guys would fade in and out of consciousness…. Some guys beat themselves up and punched themselves in the head. Some of the guys told me they had violent, ugly trips— dogs as big as horses, worms like alligators—horrible trips, being eaten by giant spiders, living in the 13th century. One guy said he was hung and killed. For a few years Al Zabala’s body would periodically break out in “strawberry rashes,”

There were tests of several other nasty agents and from what I’ve read it seems to be the same story- the tests were carried out poorly and there weren’t enough real medical professions to accurately record the results. Plus they had to discount the results as some of the prisoners had preexisting psychological issues. The prisoner’s suffering was futile.

Why Did the Prisoners Participate?

According to one prison officer- “It was more money than a prisoner had ever seen before.”

Allen Lawson was a prisoner of Holmesburg and described the city prison system and the reasons inmates were attracted to the medical experiments. He said that 84.4 percent of the prisoners were untried defendants waiting, on average, 9 months for a court date. “Almost all wait in idleness” because of lack of work. The few jobs that are available in prison pay “no more than 50 cents per day. “This lack of jobs and the prison’s failure to provide basic necessities makes the prisoners’ need for money acute.

Holmesburg held many men who were indicted and awaiting trial; under Philadelphia’s 10 percent cash bail system, $5,000 bail meant the inmate needed $500 to get back on the streets. Three or four tests at a time could mean real easy money. Foot powder tests and deodorants would bring you $100 per month, and hand creams a buck a day. You could be making $300 to $400 a month.” Though meager by outside-world standards, these wages were incredible by ordinary pay scales in prisons of the 1960s. Workers received 15 cents a day to make shoes, knit socks and shirts, sew trousers, and work in the plumbing shop.

Once the prisoners had been sucked into the lure of money with cosmetic tests, they were then tempted into more invasive tests with the offer of even more money undergoing tests for the army, a subject could make somewhere between $1,000 and $1,500.

The army tests would start off with questionnaires and examinations, all of which were well paid, culminating in experiments involving large amounts of hallucinogenics. So they were lulled into a false sense of security- $30 for a questionnaire, $50 for a physical, they had no idea what was coming for them in the actual test.

What person could say no to the money? Also there was an attitude in the prison that undergoing a test gave a sort of badge of honour, a sign of bravery.

Prisoner’s general living conditions were not great, the cells were overpopulated and uncomfortable. The experiments were a welcome escape. As well as the money, the test subjects were treated well, there was nice snacks and freezers of food to treat them with. As Klig himself says “The money was an important inducement to the inmates. Inmates went out [of prison] with hundreds of dollars,” but the program gave them “much more than a source of income.” Kligman emphasizes that it was “a welcome addition to prison routine,” which is boring and repetitive and lacks any professional or cultural stimulation. We brought in people they could talk to, says the doctor, meaning his medical staff. The program fostered “greater social activities”; it was an “antidote to boredom.”

There was no informed consent, the prisoners were not told specifically what was going to happen to them, or the short or long term consequences, the risks. No particular information was on the waivers they signed. Plus there was a lot of illiteracy among inmates and no one to explain the limited information.

They needed money for their bail, for legal representation, for phone calls, for the families they left behind and for the commissary, plus they were bored and most of the prison was in on the action.

How Did the Experiments End?

Kligman became a target for investigation by the Food and Drug Administration (FDA) in 1965 as his research program was so large: he was studying a high “number of new drugs” and was contracted by 33 different companies. In July 1966, the FDA banned Kligman from conducting drug testing at Holmesburg Prison, due to discrepancies in record keeping, and not following the conditions set out by the FDA for the testing of investigative drugs. Apparently Kligman went into a severe depression and was not seen at the university or the prison for lengthy periods of time.

However, Kligman’s ability to conduct experiments was reinstated less than a month after the initial ban after a second appeal by K. The FDA wrote that “Dr. Kligman and his associates have instituted a number of significant changes in their procedures and are now eligible to reinstitute testing” this occurred due to pressure from “significant members of the medical community, namely Drs. Donald M.Pillsbury and Luther L.Terry. Dr. Pillsbury was one of the great names in the field of dermatology, an emeritus professor, and a highly respected former chairman of the department at the University of Pennsylvania; Dr. Terry was the vice president of medical affairs at the university, but more importantly, was the former U.S. surgeon general.

Experiments on prisoners came under discussion at the 1973 Congressional Hearing on Human Experimentation.The hearing was supposed to discuss the Tuskegee Syphilis Study and clarify the ethical and legal implications of human experimental research and the practice became frowned upon by wider society.

Experimentation at Holmesburg Prison was forcibly ended by the prison’s board of trustees after the Senate Labor and Public Welfare Committee’s health subcommittee hearing on human experimentation in 1974.^Wikipedia

Until the early 1970’s, about 90 percent of all pharmaceutical products in America were tested prison inmates, federal officials say. But such research diminished sharply in 1974 after revelations of abuse at prisons like Holmesburg

As Kligman views it, the sad demise of the program was “a very good case of the triumph of the do-gooders.” The do-gooders are those “liberals, lawyers,” prison reformers, and opponents who made his experiments into “a Nazi-like thing… All we did…is offer them money for a little piece of their skin.

The Aftermath

In 1998 Kligman said about the matter of the ethics of his experiment –

“To the best of my knowledge, the result of these experiments advanced our knowledge of the pathogenesis of skin disease, and no long-term harm was done to any person who voluntarily participated in the research program.” (From the College of physicians.com) Not that they checked the long term health of the participants in any way. There is not much written about the far reaching physical effects on the subjects. Over 40 years later, Yusef Anthony still feels the effects of his experience at Holmesburg. At age 64 he must visit a doctor at least once a month, his hands sometimes swell to the size of boxing gloves, and his size 10 feet sometimes struggle to fit a size 14 shoe; just a small reminder of his contributions to science and medical advancements. He has undergone surgery to relieve his swollen hands. His feet are seemingly indefinitely warped. Despite the high levels of anguish and pain Anthony had to endure, he is still grateful, since most of his friends who went through similar prison experiments did not survive as long as he has. He has had to live in ignorance of his own condition, as he had no paperwork or information about the experiments he underwent. (princetonprogressive.com) His daughter has a go fund me, which we will link in the episode notes and on the website.

During the early 1980s, several inmates filed suit against the agencies involved in the experiments, including the City of Philadelphia, the University of Pennsylvania, Dow Chemical, and Kligman himself. One former test subject–Leodus Jones–received a $40,000 settlement from the City of Philadelphia in 1984. Leodus Jones became an activist for the cause and his daughter continues her father’s activism after his death in. 2018. She has a Facebook page Leodus_Jones.

In 1998, the year The book Acres of Skin was published several former inmates staged protests outside of the University of Pennsylvania Hospital. On October 29, 2003, ten former Holmesburg inmates, staged a protest on 22nd Street, just outside the College of Physicians of Philadelphia, while Kligman accepted his Distinguished Achievement Award.

And in 2000 298 prisoners tried to file for damages. They brought a group lawsuit for long term injuries against the University, Dermatology Professor Emeritus Albert Kligman, who lead the studies, the city of Philadelphia, and two pharmaceutical companies — Johnson and Johnson and Dow Chemical Company. The lawsuit was brought because of violations of the Nuremberg Code. The Nuremberg Code is an ethical framework for experiments involving men, it was written after the atrocities of the second world war.

It got thrown out of court because of the statute of limitations had passed. Though the suit was dismissed under the statute of limitations, the public reaction to the testing program contributed to the enactment of federal regulations restricting medical studies in prisons. At the time of the experiments those men had signed documents to say they would accept the risk to themselves when participating in the studies, and they had their money, what little of it they were given, so they probably didn’t think they had the right to complain hence the delay in bringing the lawsuit, even though they were exposed to dangerous chemicals and permanently scarred.

The University of Pennsylvania has attempted to make reparations for the pain they historically caused. This came on the 20th August 2021-

After considering the work of the committee, I have endorsed, several key changes in our recognition of the medical contributions of the late Dr. Kligman, including the development of new proactive education and experience opportunities and dedicated funding to promote respectful, equitable research and care for patients across all backgrounds, ethnicities, races and socioeconomic conditions. These actions are consistent with recommendations in the recently released Campus Iconography Report to better reflect the University of Pennsylvania’s commitment to inclusion, innovation, and impact:

Sunsetting the annual named lectureship for Dr. Kligman. The annual lecture named in honor of Dr. Kligman will be sunsetted. This decision follows the suspension of the lectureship last year pending the report of the committee.
Renaming the Kligman Professorship II to the Bernett L. Johnson, Jr., MD Professorship. Dr. Johnson was a long-time Black faculty member in the Department of Dermatology and chief medical officer of the Hospital of the University of Pennsylvania who was a steadfast advocate for diversity, equity, and inclusion. The first Bernett Johnson Professor will be Dr. Susan Taylor, who is the inaugural Vice Chair of Diversity, Equity, and Inclusion for the Department of Dermatology and an innovator in skin of color dermatology.
Establishment of Research Funding for Diversity and Equity in Dermatologic Research, Education and Care. This multi-year financial commitment will redirect research funds previously held in Dr. Kligman’s name to establish:
- Scholarships for urban high school students of all socio-economic, racial and ethnic backgrounds to participate in Penn Academy for Skin Health (PASH), a program that engages local high school students with innovative STEM research related to dermatology, with a specific segment of the program dedicated to research focused on skin of color.
- A new dermatology diversity residency position to train more dermatologists interested in skin of color and programs to support West Philadelphia residents.
- Three Research Fellowship positions for two medical students and one post-doctoral fellow to conduct research related to skin disorders among patients of color.

On the 6th October 2022 (ie last month as we are speaking!) the city of Philadelphia made a formal apology, this from Mayor Jim Kenney- “Without excuse, we formally and officially extend a sincere apology to those who were subjected to this inhumane and horrific abuse. We are also sorry it took far too long to hear these words. To the families and loved ones across generations who have been impacted by this deplorable chapter in our city’s history, we are hopeful this formal apology brings you at least a small measure of closure.”

We started this episode believing we were talking about a doctor who has done so much for so many people who are suffering, and end it with the knowledge that this man is in fact avaricious, Machiavellian and possibly psychopathic. All of the powerful scientists and prison officials involved abused the desperation of a vulnerable group. They all broke the Nuremberg code and Dr Kligman broke his Hippocratic oath.

And we are enjoying the fruits of their labour, in essence. The skincare that we love and know to be safe is only available to us because of these experiments and it is our duty to acknowledge the sacrifices that have been made. We are all too aware of the pain that animals have been put through during testing, but there were also humans that were dehumanised and caused to suffer in the long term process of the development of our skincare.